Insurance Claim

Assurance and re-insurance rights in Italy

Which general regulations, demands and processes regulate the submission of insurance entitlements? In addition to the following general principals, Italy does not lay down special detail provisions for the submission of insurance rights to insurance undertakings: After notifying the underwriter, the policyholder must submit to the underwriter the documents provided for in the insurance policies relating to the claim and take all measures to prevent an escalation of the claim.

In addition, the general rule applies that the insurance must clearly contain the regulations for the submission of a claim, the documentation that the insurance company may request from the insured/beneficiary for the evaluation of the risks and the amount of loss. However, in this context, the insurance company cannot impose an obligation on the holder to supply him with documentation which is not necessary for the evaluation of the claim.

IVASS (the Insurance Supervision Authority) published Decree 35/2010 on insurance companies' obligations to ensure transparent treatment of policy holders, which stipulates that insurance companies must lay down in the pre-contractual documents the procedure for submitting insurance claim and the necessary documents. There is a special rule for the submission of insurance entitlements for compulsory third party insurance for vehicles.

Which is the period of submission of claims? Deadlines for the fulfilment of insurance entitlements are specified in the Civil Code. In the case of non-life insurance policies and re-insurance policies, the period for submitting a claim to the insurance company shall be two years from the date on which the occurrence occurs.

In the case of endowment policies, the duration is 10 years from the date of decease of the policyholder. Reasons why an insurer may refuse cover depend on the industry and the nature of the cover. As a general rule, insurance companies refuse to indemnify a claim or make payments if: the policyholder has not paid the premium on a regular basis; the case is not included in the insurance or is expressly barred from it; the claim is time-barred; the claim is frauds or partial; the policyholder provided incorrect or partial information at the inception of the contract (under certain conditions); there is insufficient proof of the claim; the loss or incident which caused the loss or damage demanded by the policyholder arose before the insurance year.

Are there any regulations and processes regarding the rejection of a claim by the insuree? We do not have any regulations or processes that regulate the rejection of a claim by the insuree. The general regulations for civilian actions shall prevail. Legislation in Italy provides for the use of alternate redress schemes which may be adopted before a plaintiff brings a claim before the courts (i.e. the compulsory conciliation mechanism and supported hearing of all kinds of claims and the specific recourse to the referee for specific cases of allegations of breach of his code of behaviour by a broker in the distribution of insurance investment-related product).

However, the Directive explicitly precludes any complaint about the (refused) settlement of a claim by the insurance company or its amount. What are the reasons why a third person can claim a loss directly from the (re)insurer? Pursuant to the Civil Code and the Insurance Code (Legislative Decree 209/2005), third persons may assert a claim directly with the insurance company in the following cases:

As a general rule, in third parties insurance undertakings have the right to directly compensate an injured third person if the assured is first informed and the policy holder demands it; in third parties insurance policies, the designated recipient has the right to demand lump-sum payments resulting from the assured's deaths.

Does the insurance cover penalty payments? It is not possible to insure penalty damage under Italy because neither the legislation nor the jurisprudence recognise penalty damage claims in litigation. In Italy, a court may order a plaintiff to pay reparation only for tangible and intangible damage caused by the immediate effects of a particular incident.

Therefore, insurance companies active in Italy do not provide coverage for the penalty risks. A recent Supreme Court ruling on the execution of a judgement of a foreign court ordering the award of penalty compensation, however, seems to acknowledge to some degree the potential for such harm. According to the provisions of the German Code of Obligations, the insurance company that compensates the policyholder for the losses incurred may bring a claim against the third person responsible for the losses incurred by the policyholder.

The right to this transfer is governed by certain statutory provisions and is restricted to the same amount as the Insurer pays to the policyholder. Insurers shall continue to be responsible for damage resulting from the exercise of the right of recourse.